WO2001078621A2 - Systeme d'implant dentaire - Google Patents

Systeme d'implant dentaire Download PDF

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Publication number
WO2001078621A2
WO2001078621A2 PCT/US2001/040535 US0140535W WO0178621A2 WO 2001078621 A2 WO2001078621 A2 WO 2001078621A2 US 0140535 W US0140535 W US 0140535W WO 0178621 A2 WO0178621 A2 WO 0178621A2
Authority
WO
WIPO (PCT)
Prior art keywords
implant
bone
coronal
facial
implant body
Prior art date
Application number
PCT/US2001/040535
Other languages
English (en)
Other versions
WO2001078621A3 (fr
Inventor
Glenn L. Gittelson
Thomas G. Ford
Original Assignee
Gittelson Glenn L
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Gittelson Glenn L filed Critical Gittelson Glenn L
Priority to AU2001255846A priority Critical patent/AU2001255846A1/en
Publication of WO2001078621A2 publication Critical patent/WO2001078621A2/fr
Publication of WO2001078621A3 publication Critical patent/WO2001078621A3/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0018—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools characterised by the shape
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0001—Impression means for implants, e.g. impression coping
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0048—Connecting the upper structure to the implant, e.g. bridging bars
    • A61C8/005—Connecting devices for joining an upper structure with an implant member, e.g. spacers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0048—Connecting the upper structure to the implant, e.g. bridging bars
    • A61C8/0077—Connecting the upper structure to the implant, e.g. bridging bars with shape following the gingival surface or the bone surface
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0048—Connecting the upper structure to the implant, e.g. bridging bars
    • A61C8/005—Connecting devices for joining an upper structure with an implant member, e.g. spacers
    • A61C8/006—Connecting devices for joining an upper structure with an implant member, e.g. spacers with polygonal positional means, e.g. hexagonal or octagonal
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0048—Connecting the upper structure to the implant, e.g. bridging bars
    • A61C8/005—Connecting devices for joining an upper structure with an implant member, e.g. spacers
    • A61C8/0069—Connecting devices for joining an upper structure with an implant member, e.g. spacers tapered or conical connection

Definitions

  • This application relates to single or multiple fixed prosthodontic restora- tions, and more particularly to a dental implant system which simulates the look and function of a natural root of a tooth with regard to its maintenance of bone and gingival architecture.
  • Implants provide a structure upon which a prosthetic tooth or teeth can be attached and secured in an otherwise edentulous (non-tooth) area.
  • implants In contrast to using dentures or other fixed or removable dental bridge systems, implants have the advantage of maintaining bone and not being subject to decay.
  • a primary concern in implant dentistry is the presence of sufficient bone support, which not only is necessary for proper placement and securement of the implant itself, but is critical for the proper development and maintenance of gingival tissue including papilla that is necessary in order to achieve a desirable soft-tissue aesthetic result.
  • Bone growth around an implant follows the shape of the bone-integrating part of the implant.
  • conventional side-by-side flat- ended implants bone support between the implants is flat and therefore the gingiva between the implants is also flat.
  • Such a flat gingival configuration produces an artificial looking, unnatural and aesthetically displeasing appearance in the patient's mouth.
  • Grafting techniques for replacing papilla around implants have also been used, but they are almost always very costly and ineffective, especially in the case of multiple side-by-side implants. Also, grafting is less than desirable due to the typical requirement of undertaking several painful surgical procedures and the lack of predictability for success in these operations, the latter due to an inadequate amount of bone support between the implants.
  • gingival colored porcelain on the crowns
  • the use of gingival colored porcelain is completely unsatisfactory since the look is artificial, out of proportion, and out of contour.
  • an improved dental implant system which maintains the boney/osseo and gingival soft tissue architecture in a scalloped appearance similar to what appears around a healthy natural root of a tooth. This promotes the growth and maintenance of proper gingival tissue contours, specifically papilla, in the necessary locations along the gingival architecture such as would appear around a natural tooth.
  • an improved dental implant system which simulates the natural root of a tooth.
  • the system includes an implant body having a facial surface aspect, lingual surface aspect and interproximal surface aspect, and which is defined by an apical portion and a coronal portion.
  • the system also includes an implant abutment having an internal surface aspect for selective mating engagement with the coronal portion of the implant body and also having an external surface aspect.
  • the system further includes a crown having an internal surface aspect for selective mating engagement with the external aspect of the implant abutment.
  • the implant body has a bone integrating external surface which, in a coronal direction, extends more along the interproximal aspect than along the facial aspect.
  • the bone integrating external surface defines a non-bone integrating beveled surface along the facial aspect of the coronal portion of the implant body. This beveled surface is not integrated to the bone and is designed for maintaining a boney scallop around the implant and for selective mating engagement or attachment with the internal aspect of the implant abutment during assembly of the inventive system.
  • the bone integrating external surface also defines a second non-bone integrating beveled surface along the lingual aspect of the coronal portion of the implant body.
  • the second beveled surface is also designed for engagement or attachment with the internal aspect of the implant abutment.
  • each beveled surface formed along the coronal portion of the implant body comprises a facial scallop having an apical extent and a coronal extent.
  • Each beveled surface defines a taper viewed along the interproximal aspect and which extends inwardly from the apical extent to the coronal extent at an angle of an amount between about 5° and 25°.
  • the implant body of the inventive dental implant system has a bone integrating external surface which, in a coronal direction, extends more along the interproximal aspect than along the facial and lingual aspect, bone formation is naturally guided to a more apical location along the facial and lingual aspects, thereby creating a scalloped boney design around the implant body.
  • gingival tissue is formed along the scalloped bone, promoting the formation of papilla between adjacent implants when the final prosthesis is in place with a properly located tooth contact point.
  • Another object of the invention is to provide a dental implant system which simulates the design and function of a natural root of a tooth.
  • a further object of the invention is to provide a dental implant system which enables bone to be formed and maintained around the implant body thereof at two different heights or levels.
  • Still another object of the invention is to provide an improved dental implant system which enables the formation and maintenance of papilla between side-by- side implants and/or adjacent natural teeth.
  • Yet a further object of the invention is to provide a dental implant system which has a non-bone integrating beveled surface along at least a facial aspect of the coronal portion of the implant body. Still other objects and advantages of the invention will in part be obvious and will in part be apparent from the following description.
  • Fig. 1 is a front elevational or facial view of three side-by-side natural teeth and their corresponding roots in bone with proper tooth contacts and papilla formation;
  • Fig. 2 is a front elevational or facial view in partial cross-section of a prior art implant design disposed in the mouth;
  • Fig. 3 is an exploded perspective view of the inventive implant system and showing the implant body, implant abutment, abutment retaining screw and crown components;
  • Fig. 4 is a cross-sectional view taken along line 4-4 of Fig. 3;
  • Fig. 5 is a side elevational or interproximal view of the implant body of the inventive implant system
  • Fig. 6 is a bottom plan or coronal view of the implant body of the inventive implant system
  • Fig. 7 is a front or facial cross-sectional view showing the step of insertion of the implant body of the inventive implant system into where the tooth root was previously located in the bone;
  • Fig. 8 is a front or facial cross-sectional view showing attachment of the implant healing abutment and temporary crown to the implant body of the inventive implant system;
  • Fig. 9 is an exploded perspective view of the implant impression coping of the inventive implant system.
  • Fig. 10 is a cross-sectional view showing the implant impression coping in an assembled condition and attached to the implant body in the mouth;
  • Fig. 11 is a cross-sectional view showing the implant body analogue secured to the implant impression coping
  • Fig. 12 is a front elevational or facial view showing the laboratory stone model with the implant body analogue in place;
  • Fig. 13 is a partial front or facial cross-sectional view showing the attachment of the implant abutment to the implant body via the implant abutment screw and the insertion of a plug into the opening of the implant abutment of the inventive implant system
  • Fig. 14 is a front or facial cross-sectional view showing attachment of the crown to the implant abutment and attachment of the implant abutment to the implant body via the implant abutment screw of the inventive implant system ;
  • Fig. 15 is a front elevational or facial view showing side-by-side implants of the inventive implant system with final prosthesis in place and disposed in a patient's mouth;
  • Fig. 16 is an enlarged front elevational or facial view in partial cross-section similar to what is shown in Fig. 15;
  • Fig. 17 is a cross-sectional view taken along line 17-17 of Fig. 16.
  • FIG. 1 the upper part of the mouth generally indicated at 10 and depicting a series of natural teeth is shown.
  • Upper part of mouth 10 includes bone 11 in which three natural teeth 12 are retained.
  • Each tooth 12 has a depending tooth crown 17 and a tooth root 13 for connection to bone 11.
  • Each of tooth crowns 17 has an incisal edge 14 and an apical extent 16 along the crest of bone 11.
  • bone 11 , root 13 and crown 17 together define a gingival architecture having a scalloped appearance such that papilla 15 is located between teeth crowns 17 and has a base 18 which, in a coronal direction, depends more interproximally than it does along the facial area of teeth crowns 17.
  • Base 18 is located not more than 5 mm from interproximal crestal bone 11 A.
  • FIG. 2 shows a series of side-by-side prior art implant units 20 disposed in the mouth.
  • Each implant unit 20 includes an implant body 19, an implant abutment 21 and a crown 35.
  • Implant abutment 21 is coupled to implant body 19 by means of an abutment screw 23.
  • Abutment screw 23 includes a screw head 25 and a threaded screw body 27.
  • Implant body 19 is formed with a coronal plate 31 on which a threaded hex nut 33 is mounted and which overlies a screw hole 34.
  • Implant abutment 21 is formed with a screw passage 29 which receives head 25 of abutment screw 23 when screw body 27 is engaged within screw hole 34 of implant body 19.
  • each of implant bodies 19 is flat where it exits bone 11 (the crestal bone-impla ⁇ t interface), bone 11 is also flat, and thus gingival architecture is flat.
  • papilla 15' located between implant units 20 is substantially flat in appearance, thereby creating open or black spaces 36, which are aesthetically unacceptable.
  • Dental implant assembly 51 includes an implant body 53, an implant abutment 73 and a crown 91.
  • Implant body 53 is made from a bone integrating metal material such as a titanium alloy with a roughened surface and has an elongated cylindrical configuration.
  • Implant body 53 has a facial surface aspect 55, a lingual surface aspect 57 and an interproximal surface aspect 59.
  • Implant body 53 consists of an apical portion 61 and a coronal portion 63.
  • Implant body 53 has a bone integrating external surface 58 which in a coronal direction extends more along interproximal aspect 59 than along facial aspect 55 or lingual aspect 57.
  • Bone integrating external surface 58 defines a non-bone integrating beveled surface 65 made of a machined smooth or polished metal surface along both facial aspect 55 and lingual aspect 57 of coronal portion 63 (see Figs. 3 and 4).
  • Each beveled surface 65 has a scalloped shape defined by an apical extent 64 and a coronal extent 66 that measures a distance A therebetween of 2 and 6 millimeters (see Fig. 16).
  • beveled surfaces 65 are designed for maintaining a boney scallop around coronal portion 63 of implant body 53 and for mating engagement with implant abutment 73, as discussed below.
  • Implant body 53 also includes a coronal plate 67 of polished or machined smooth metal on which a hex nut 69 is mounted (see Fig. 6). Hex nut 69 has a series of internal threads 70 and leads into a screw hole 71 which also has internal threads formed inside coronal portion 63 of implant body 53 for selectively receiving the body of a retaining abutment screw, as described later on. Between bone integrating external surface 58 and non bone-integrating beveled surfaces 65, there is formed a smooth, thin non-bone integrating collar 60 which follows the scalloped shape of beveled surfaces 65 and also runs interproximally adjacent coronal plate 67. Collar 60 is also polished or machine smooth metal and has a width of between about ⁇ mm to 1 mm. Collar 60 serves as an interface for the gingival architecture to adhere thereto and thereby initiate the scalloped appearance of the gingival tissue.
  • implant abutment 73 of implant assembly 51 is made from a polished or machined smooth metal material such as a titanium alloy and is non-bone integrating.
  • Abutment 73 has a cup-shaped configuration formed with an internal surface aspect 75 designed for selective mating engagement with coronal portion 63 of implant body 53 along non-bone integrating beveled surfaces 65.
  • Implant abutment 73 also includes an external surface aspect 77 which leads to a coronal end 79 formed with an abutment opening 81 for receiving an abutment screw 83 comprising a circular head 85 and a cylindrical body 87, as described in greater detail hereinbelow. As best shown in Fig.
  • opening 81 includes a first wider passage 84 that leads into a second, narrower passage 82 and which together define an annular seating surface 86 on which head 85 of screw 83 is designed to rest.
  • Crown 91 as shown in Figs. 3 and 14, has a cup-shaped configuration with an internal surface aspect 95 designed for mating engagement with external aspect 77 of implant abutment 73.
  • Crown 91 is made from conventional dental metals and porcelain and also includes an external aspect 93 which leads to an incisal edge 94.
  • Crowns 91 as shown in Fig. 16, have an interproximal contact point 94' where adjacent teeth touch and which serves to help form the base of papilla.
  • implant assembly 51 of the invention is permanently affixed to bone 11 inside the mouth.
  • the implant can be placed at the time of tooth extraction or in a previ- ously edentulous site, provided adequate bone is present or can be grafted to the site, as is well known.
  • implant body 53 is fitted inside site 50 with plate 67 of coronal portion 63 extending flush with interproximal crestal bone 11 A of bone 11 (see Fig. 7).
  • a cover screw (not shown) is secured to hex nut 69 while implant body 53 is submerged inside bone 11.
  • Healing time is approximately 3-6 months, during which implant body 53 is integrating to bone 11.
  • a temporary or healing abutment 73' made of a plastic material is secured to non-bone integrating beveled surface 65 of coronal portion 63 of implant body 53 by means of a screw 83' comprising a head 85' and a body 87'. This allows for proper soft tissue healing and as a means of initiating final soft tissue contours.
  • Temporary or healing abutment 73' may also retain a temporary crown 91 ' made of a plastic material in order to form and maintain papilla in a fashion similar to the final prosthesis.
  • fabrication of the final implant supported crown or bridge prosthesis can be initiated. This is done with the use of implant impression copings and implant body analogues which are unique to the inventive system due to their shapes.
  • An impression coping transfers the relationship of the implant and surrounding soft tissue in the mouth to the lab.
  • the implant body analogue simulates the actual implant in the laboratory setting.
  • Impression coping 102 has a shaft 104 extending therefrom and is secured to coronal plate 67 and non-bone integrating beveled surface 65 of coronal aspect 63 of implant body 53 by means of screw 103. Screw 103 passes through shaft 104 for engagement to hex nut 69.
  • Impression tray 105 is seated in the mouth with head 108 of impression coping screw 103 accessible through tray hole 106.
  • the entire assembly, as shown in Fig. 10, is allowed to set for approximately 6 minutes to allow for hardening of impression material 104.
  • implant impression coping screw 103 is loosened and impression tray 105 is removed from the mouth with implant impression coping 102 embedded in impression material 107, which is held in impression tray 105.
  • an implant body analogue 120 is attached to implant impression coping 102 via implant impression coping screw 103.
  • This assembly is then poured in conventional dental stone to create a working dental laboratory model 121.
  • Laboratory model 121 as seen in Fig. 12, with implant analogue 120 in place, reproduces the position of the implants in the mouth. It also serves to reproduce the soft tissue gingival contours including papillas 122 around the implants as well as adjacent tooth contours.
  • This model 121 is used to assemble implant abutments 73 and to create the final implant supported dental crown or bridge prosthesis.
  • implant abutment 73 is now coupled to coronal portion 63 of implant body 53 such that internal aspect 75 matingly engages coronal portion 63 along beveled surfaces 65 with abutment opening 81 aligned with screw hole 71 formed within coronal portion 63 of implant body 53.
  • the underside of screw hole 81 of implant abutment 73 has the female equivalent
  • abutment screw 83 is used to secure implant abutment.73 to implant body 53.
  • Abutment screw 83 includes head 85 formed with an outside operating slot 89 (see Fig. 3) and screw body 87 formed with a plurality of outer threads 88.
  • abutment screw 83 is first inserted into abutment opening 81 of abutment 73 through first passage 84 such that screw body 87 is enabled to be rotatably threaded through hex nut 69 and into screw hole 71.
  • plug 81A made of a plastic rod material of the same dimension as abutment opening 81 and is cut in length to fit this space.
  • the purpose of plug 81A is to prevent microvibration of implant abutment 73 during function from loosening screw 83 and thereby prevent it from backing out of abutment opening 81 .
  • crown 91 is then coupled over implant abutment 73.
  • internal aspect 95 of crown 91 is engaged to external aspect 77 of implant abutment 73 by means of a conventional dental cement 96.
  • several implant assemblies 51 may be used to replace side-by-side teeth, creating the configuration depicted in Figs. 15 and 16.
  • the gingival or gum tissue 100 assumes a scalloped appearance as it follows the shape of bone integrating external surface 58 of implant body 53 (see Fig. 14).
  • papilla 15A is formed between the side-by-side implant assemblies 51 of the invention and has an interproximal base 99 (corresponding to the contact point 94' between adjacent crowns 91) which measures a distance B not greater than 5 mm past interproximal crestal bone 11 A of bone 11. This is in direct contrast to all other prior art techniques, which fail to enable papilla to form naturally between adjacent implants producing aesthetically unacceptable black spaces where the papilla is normally located.
  • each beveled surface 65 defines a taper C (Fig. 5) when viewed along interproximal aspect 59 which, in accordance with the invention, extends inwardly towards underlying plate 67 in an amount between about 5 and 25 degrees. It is important to have this taper in order to create an appropriate path of insertion for the securement or attachment of the implant abutment to the implant body as well as to allow for the attachment and securement of the crown or prosthesis to the implant abutment and to allow for proper crown/prosthetic contours.
  • a significant feature of the inventive design is the inclusion of a non-bone integrating beveled surface along the facial aspect of the coronal portion of the implant body for maintaining bone around the implant body at two different levels in side-by-side implants and/or adjacent natural teeth, thereby allowing gingival tissue to be maintained also at two different levels so that a scalloped natural looking appearance of the gingival tissue including papilla is produced.

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  • Health & Medical Sciences (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Dentistry (AREA)
  • Epidemiology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Dental Prosthetics (AREA)

Abstract

L'invention concerne un système d'implant dentaire amélioré qui simule la racine naturelle d'une dent. Le système comprend un corps d'implant à aspects de surfaces facial, lingual et interproximal, et défini par des portions apicale et radiculaire. Le système comprend encore un point d'appui d'implant doté d'un aspect de surface interne destiné à s'apparier avec la partie radiculaire du corps d'implant, et aussi d'un aspect de surface externe. Le système comprend enfin une couronne à aspect de surface interne destinée à s'apparier sélectivement avec l'aspect externe du point d'appui de l'implant. Il est significatif que le corps d'implant comporte une surface externe d'intégration osseuse qui, dans une direction radiculaire, s'étend plus le long de l'aspect interproximal que le long de l'aspect facial. En particulier, la surface externe d'intégration osseuse définit une surface biseautée sans fonction d'intégration osseuse le long de l'aspect facial de la portion radiculaire du corps de l'implant. Cette surface biseautée ne s'intègre pas à l'os et elle est conçue pour maintenir une échancrure osseuse et une échancrure gingivale subséquente avec une papille autour de l'implant, et pour un appariement sélectif ou un attachement avec l'aspect interne du point d'appui lors de l'assemblage du système de l'invention.
PCT/US2001/040535 2000-04-18 2001-04-17 Systeme d'implant dentaire WO2001078621A2 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU2001255846A AU2001255846A1 (en) 2000-04-18 2001-04-17 Dental implant system

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
US19802500P 2000-04-18 2000-04-18
US60/198,025 2000-04-18
US09/636,166 US6431867B1 (en) 2000-04-18 2000-08-10 Dental implant system
US09/636,166 2000-08-10

Publications (2)

Publication Number Publication Date
WO2001078621A2 true WO2001078621A2 (fr) 2001-10-25
WO2001078621A3 WO2001078621A3 (fr) 2009-06-04

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US (1) US6431867B1 (fr)
AU (1) AU2001255846A1 (fr)
WO (1) WO2001078621A2 (fr)

Cited By (4)

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EP1321109A1 (fr) * 2001-12-18 2003-06-25 Riccardo Tizzoni Système d'implant dentaire avec un implant ayant une tête à parois inclinées
WO2004002359A1 (fr) * 2002-06-28 2004-01-08 Centerpulse Dental Inc. Interface formee organique pour dispositifs d'implants dentaires
US7540879B2 (en) 2000-02-18 2009-06-02 E.V.R. Endovascular Researches S.A. Endolumenal device for delivering and deploying an endolumenal expandable prosthesis
CN102131476A (zh) * 2008-08-26 2011-07-20 泽斯特Ip控股有限公司 牙齿锚定设备和方法

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US20070031792A1 (en) * 2005-08-03 2007-02-08 Kelley Casement Provisional crown for dental implants
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US10709525B2 (en) 2012-01-10 2020-07-14 Esthetic Implant Solutions, Llc Methods for taking an oral scan without requiring removal of a temporary healing abutment
US10016260B2 (en) 2012-01-10 2018-07-10 Mark H. Blaisdell Anatomical healing abutments, kits, and methods
US10507081B2 (en) 2012-01-10 2019-12-17 Esthetic Implant Solutions, Llc Methods for taking an impression or scanning without requiring removal of a temporary healing abutment
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